OrganizationActive
Ellen Fan M D P a
NPI 1467890178 · Geriatric Psychiatry Physician · Dallas, TX
Provider details
- NPI number
- 1467890178
- Entity type
- Organization
- Primary specialty
- Geriatric Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ellen Fan, Physician(972) 769-8572
- License
- K8897 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
8240 Manderville Ln
Dallas, TX 75231-1104
Phone: (972) 769-8572
Fax: (972) 769-8591
Approximate (ZIP-level) locationGet directions
Mailing address
3308 Preston Rd
Plano, TX 75093-7453
Registry dates
- Enumerated
- 2013-06-05
- Last updated
- 2025-05-29
- Certified
- 2025-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.